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What to know before putting your child on an antidepressant

Posted June 14

Only 1 out of 14 commonly prescribed antidepressants is effective in children and teens, and at least one is associated with an increased risk of suicide, a new study says.

The findings affect a small but growing number of U.S. families with children who have been diagnosed with depression. About 1.6 percent of American children and teens took antidepressants in 2012, the latest year when figures were available. Few may have been helped, according to CBS News, which reported on multinational research published June 8 in the medical journal The Lancet.

Researchers analyzed the outcomes of 34 clinical trials involving 5,260 children and teens. Out of 14 antidepressants they took, only one outperformed placebos. It was fluoxetine, better known to consumers as Prozac or Sarafem.

"When considering the risk–benefit profile of antidepressants in the acute treatment of major depressive disorder, these drugs do not seem to offer a clear advantage for children and adolescents," the authors concluded.

Previous studies have shown a link between antidepressants and suicidality. The British researchers found an increased risk of suicide attempts and thoughts especially among children and teens who took the drug venlafaxine, sold as Effexor.

The lead author of the study, Dr. Andrea Cipriani of the University of Oxford, told CBS News that the findings confirm the need for caution when putting children and teens on antidepressants "because we don't know the potential implications in the long term for a developing brain."

Everyone gets down once in a while, but major depressive disorder, also called clinical depression, is diagnosed when feelings of sadness, anxiety and hopelessness don't go away, and are accompanied by fatigue, sleep problems, weight changes and other physical ailments, according to the National Institutes of Health.

The symptoms of clinical depression in children and adults are identical but for one thing: Children are more likely to be irritable than sad.

About 3 percent of children under 12 and 6 percent of adolescents experience depression, and the incidence of depression among children is thought to be rising because, in part, of social-media pressures, materialism and the prevalence of divorce.

Genetics are also thought to play a role in up to half of cases. And one Boston College professor, Peter Gray, has blamed the decline of free play, which gives children a sense of control and exposes them to the outdoors, which has been shown to reduce depression, hence, the rise of ecotherapy.

Other risk factors for childhood depression include obesity, illness such as diabetes or asthma, low birth weight and being born to a teen mother.

International guidelines suggest first treating young people with depression with cognitive behavioral or interpersonal therapy, Ashley Welch of CBS News reported.

Other strategies include meditation, yoga and relaxation techniques, recommended by the Anxiety and Depression Association of America, and exercise and massage, recommended by The Cleveland Clinic.

Medication should be a last resort, and if then, it should be fluoxetine, the one antidepressant in the study to show value, child psychiatrist Dr. Jon Jureidini told Karen Weintraub of STAT.

“No one should be on any other antidepressant, and I think it’s doubtful that people should be on Prozac, as well," said Jureidini of the Robinson Research Institute at the University of Adelaide in Australia.

EMAIL: jgraham@deseretnews.com

TWITTER: @grahamtoday

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